Adapted from BMJ 23rd Nov 19. A chronic problem with language by Dr Helen Salisbury
Helen is a GP in Oxford she writes…..
Some years ago I was told the term “chronic disease” had been replaced by “long term condition”. When I asked my non medical friends about it, they thought that both “chronic” and “acute” both meant “severe”. My comment: whereas they mean something more like “long lasting” and “short lasting” to a doctor.
So a chronic disease sounds like one likely to harm or kill you, whereas a long term condition sounds like something you live with but not die from. As doctors now copy patients into their letters, then perhaps we need to be more responsive to their beliefs?
Impaired renal function, from natural ageing is one of the problems that has arisen from the misunderstanding of the term “chronic kidney disease”. It can cause people real worry because they imagine that they are a candidate for dialysis or death, yet they are unlikely to be affected symptomatically, nor is it likely to hasten death. Heart failure is another term that causes a lot of distress.
Sometimes doctors need to be precise in their speech and letters to each other so we can’t abandon all technical language. Copying clinic letters to patients is good practice, even if patients sometimes struggle to understand them completely, because they have a record of the consultation and a chance to clarify the decisions made.
Sometimes we could use more lay terms to reduce confusion. Abandoning “chronic disease” is a good start.